Tobacco & Nicotine Delivery Products Sales
Apr 09, 2020
submission
#71
Petitioner Application
Application
| Type of Licence | --- |
| Business Name | --- |
| Business Address | --- |
| Business Telephone | --- |
| Owner's Name | --- |
| Owner's Address | --- |
| Owner's Telephone | --- |
| Emergency Response Person | --- |
| Emergency Person Telephone | --- |
| MA Dept. of Revenue Retaoler's License for Sale of Cigaretts # | --- |
| Type of Products Sold | --- |
| Other | --- |
| Federal Tax ID Number | --- |
| Type of Application | --- |
Petitioner Document Check
Documents
| Copy of Cigarette Retailer's License, issued by Massachusetts Department of Revenue | --- |
| Certificate of Good Standing from the Massachusetts Department of Revenue; masstaxconnect.com | --- |
| A Certificate of Insurance showing workers compensation insurance or Certificate of Compliance , in accordance with Section 25C of Chapter 152 of Massachusetts General Laws. | --- |
| Proof that any/all tobacco sales citiations have been paid | --- |
| Certificate of Occupancy (obtained at Inspectional Services Department) | --- |